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Impact of tourniquet use in total knee arthroplasty on functional recovery and postoperative pain: a prospective study

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Tourniquet use during total knee arthroplasty (TKA) remains controversial. The purpose of this study is to determine the impact of tourniquet use only during cementation compared with its use throughout the entire surgery concerning early outcomes in functional recovery, pain, quadriceps function, and rehabilitation.

Methods

Between November 2019 and March 2020, 118 patients were enrolled in this study, with 59 patients undergoing TKA with a tourniquet during the entire surgery (group 1) and 59 patients with a tourniquet only during cementation (group 2). Twenty-eight patients were unable to complete follow-up leaving fifty in group 1 and forty in group 2. Primary endpoints were surgical time, postoperative knee and thigh pain, and functional recovery. Secondary endpoints were 6-month clinical scores and blood loss.

Results

Patients in group 1 had statistically significantly increased knee pain on postoperative day 3 (p = 0.004), and thigh pain on postoperative day 1 (p < 0.001), 2 (p < 0.001), and 3 (p = 0.027), and longer time intervals to achieve straight leg raise maneuver (p = 0.006) compared to group 2.

However, it did not affect overall narcotic consumption, knee pain (day 1–2), functional recovery, ROM, ability to do the first walk, Oxford knee score, length of stay, and complication rate.

There was no statistically significant difference in terms of 6-month postoperative knee score, surgical time, and blood loss between the two groups.

Conclusion

Tourniquet use diminishes quadriceps function and increases postoperative thigh pain and, to a lesser extent, knee pain. We, therefore, recommend the use of a tourniquet only during cementing.

Level of evidence

1; prospective randomized study.

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Data availability

The data that support the findings of this study are available from the corresponding authors upon reasonable request.

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Acknowledgements

We would like to acknowledge the essential collaboration of the physiotherapist involved in patient rehabilitation.

Funding

No financing was received for this study.

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Authors and Affiliations

  1. Department of Orthopedics and Trauma Surgery, CHIREC Hospitals, Boulevard Brand Whitlock 1, Woluwe-Saint-Pierre, 1150, Brussels, Belgium

    Gautier Beckers, David Mazy, Eric Manche & Bernard Geulette

Authors
  1. Gautier Beckers
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  2. David Mazy
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  3. Eric Manche
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  4. Bernard Geulette
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Contributions

Study design, BG, EM, and GB; data collection, DM and GB; data analysis, DM and GB; writing of manuscript, GB; editing of manuscript, BG, EM, DM, and GB; surgeons, BG and EM; revision and final approval of the manuscript BG, EM, DM, and GB.

Corresponding author

Correspondence to Gautier Beckers.

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Conflict of interest

Bernard Geulette, Eric Manche, David Mazy, and Gautier Beckers: None.

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Beckers, G., Mazy, D., Manche, E. et al. Impact of tourniquet use in total knee arthroplasty on functional recovery and postoperative pain: a prospective study. Arch Orthop Trauma Surg 144, 1361–1367 (2024). https://doi.org/10.1007/s00402-023-05158-5

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  • DOI: https://doi.org/10.1007/s00402-023-05158-5

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